Help Interpreting MRI Report

[Maximode]

Hello,

I just received a copy of my first MRI results, and I will be meeting with my Urologist in a few days to go over it. I was hoping for some clarity on what it means. My bio has the latest info of my PC journey and is listed below, thanks everyone for your support!

Quick Bio:

Sept 01, 2022: PSA 9.0

Sept 27, 2022: PSA 9.2

Oct 11, 2022: 12 core biopsy - Gleason 3+3, 3+4, 3+4 cancer found on 3 cores (G7 favorable grade 2).

Oct 15, 2022: Major lifestyle change

Nov 22 2022: PSA 7.9

Dec 23, 2022: PSA 6.8

Jan 19, 2023: PSA 6.0

Jan 23, 2023: MRI

Jan 23, 2023 MRI Report from UCLA:

Preliminary Result

3T MRI OF THE PROSTATE WITH AND WITHOUT CONTRAST

and with 3D post-processing

TECHNIQUE: MRI of the pelvis was performed on a 3 Tesla

Siemens Skyra scanner. A transabdominal phased array was

used. Small field of view sagittal, axial oblique and coronal

oblique T2W TSE high resolution images and diffusion weighted images with

apparent diffusion coefficient map were obtained. Pre- and postcontrast

axial dynamic view-sharing time-resolved gradient

recalled echo T1-weighted images are acquired with intravenous

administration of gadolinium contrast. Offline post-processing on a

dedicated InVivo DynaCAD 3 workstation was performed for

generation of time-intensity curves and pharmacokinetic maps

and 3D contouring of the prostate gland and any target lesions

using combined automated and manual segmentation techniques.

CONTRAST: gadobutrol (Gadavist) 1 mmol/mL inj 7.5 mL

GLUCAGON: No

COMPARISON: No prior MRI prostate available for comparison at the time of dictation.

CLINICAL HISTORY: prostate cancer

PSA (ng/mL): 9.2 on 9/2022

BIOPSY: Gleason 3+4=7 adenocarcinoma in 2 cores on

10/11/2022 with Genesis Healthcare Partners in OC

FINDINGS:

Quality: Excellent

The prostate measures 32 g based on contour, (4.5 cm x 3.3 cm x 3.9 cm).

PSA Density 0.29 ng/mL/cc.

The background transition zone is heterogeneous.

The background peripheral zone is heterogeneous. Linear and wedge-shaped T2 hypointensities throughout the peripheral zone (worse on the left) likely represent prostatitis or sequela

thereof.

Additional T1 hyperintense probable postbiopsy blood products at the left peripheral apical mid gland.

No suspicious findings for intermediate or high-grade neoplasia.

Limited views of the pelvis reveal no enlarged lymph nodes.

No focal bone lesions.

IMPRESSION:

No suspicious findings for intermediate or high-grade neoplasia.

Overall PI-RADS Category: 2/5

Standardized reporting guidelines follow recommendations by ACR-ESUR PI-RADS v2.1

THIS IS A PRELIMINARY REPORT THAT HAS NOT BEEN

REVIEWED BY AN ATTENDING RADIOLOGIST.

*Modified PI-RADSv2.1 Scoring for Dynamic Contrast-Enhanced

Imaging is utilized at UCLA as follows: a peripheral zone lesion

will only be considered positive if it corresponds to a focal

abnormality on T2-weighted and diffusion-weighted imaging and

enhances earlier than (not contemporaneously with) surrounding normal peripheral zone tissue.

Appendix (based on UCLA data/publications)

Overall MRI sensitivity for prostate cancer detection = 47%

Sensitivity for tumors > 1 cm or for Gleason > 3 + 4 = 72%

In-Bore MR-Guided Biopsy

PI-RADS 2: 7% PI-RADS 1/2: 15%

PI-RADS 3: 44% PI-RADS 3: 23%

PI-RADS 4: 63% PI-RADS 4: 64%

PI-RADS 5: 94% PI-RADS 5: 80%

CDR MR/US Fusion Biopsy CDR

1. Eur Urol 2019;75(5):712-720

2. Radiology 2017;283(1):130-139

3. Cancer 2016;122(6):884-892

4. Abdom Radiol 2016;41:954-962

5. Eur Urol 2015;67(3):569-576

6. Am J Roentgenol 2015;1:W87-92

Dictated by: (redacted) 1/23/2023 6:27 PM

[Tall_Allen]

It means no suspicious lesions were found on mpMRI - Congratulations! But why are you posting on an advanced prostate cancer forum?

[Maximode in reply to Tall_Allen]

Hey TA, I read a lot of your post, thank you for the reply. Being this is my first post, I wasn't sure where to post, thanks again!

[Tall_Allen in reply to Maximode]

Try the following. There are more guys in your situation:

healthunlocked.com/prostate...

[Boywonder56 in reply to Maximode]

Get outa here why you gots a chance....good luck to you....hope we never see ya.....hey darylle .....time to change the secret knock.....🤣

[NotDFL]

I hate to counter Tall Allen, but the biopsy clearly showed that you do have cancer in your prostate. The finding that the MRI didn't show this is pretty irrelevant. It's unlikely that your Gleason 7 cancer just disappeared in a few months!

[Maximode in reply to NotDFL]

Thank you NotDFL for the reply. After reading through the PI-RADs v2 specs and other research, I found the answers I was looking for in this post. I’ll repost this over in the Prostate Cancer forum, in a way that better describes my situation and the open questions I have.